Persons with serious mental illness (SMI) have a large burden of medical comorbid conditions and mortality rates two to over three times higher compared to the overall population, constituting a public health crisis for mental health consumers and their families. NIMH's Strategic Plan, the Institute of Medicine and SAMSHA all emphasize decreasing mortality for persons with SMI as priorities. At the same time, a wide gap exists between effective health interventions in research settings and translation into the community. Achieving the goals of reducing disparities in overall health and mortality for those with SMI requires investigators with varied expertise, particularly in implementation research, to effectively translate interventions to improve health. This revised application for an NIMH K24 Mid-Career Investigator Award in Patient-Oriented Research seeks support for a primary care physician dedicated to a career in clinical research to decrease medical morbidity and mortality and improve overall health in persons with SMI. Dr. Daumit is a practicing general internist, epidemiologist and health services researcher with a longstanding commitment to patient oriented investigation, reflected in her research program and mentoring of junior investigators. Bridging mental health and medical fields, she successfully builds multidisciplinary teams in her current work to develop and evaluate appropriately adapted behavioral lifestyle interventions for persons with SMI. She is thus uniquely poised to grow as a leader in the effort to improve implementation and sustainability of proven interventions that promote health and quality of life for persons with SMI. Her immediate career objectives are: 1) To acquire skills in implementation research theory and methods including mixed methods designs to evaluate sustainability of interventions to decrease health risks in persons with SMI; 2) To amplify her work in understanding causes for increased mortality in persons with SMI and in developing and implementing sustainable person-level and systems-level strategies for improving physical health; and 3) To continue to provide outstanding mentorship for junior clinician investigators and attract new investigators to mentor in the conduct of rigorous patient- oriented research to address health issues in persons with SMI. Through the K24, she will gain new knowledge in implementation research methods and apply these techniques to translate sustainable solutions into practice and policy, improve physical health in this vulnerable population, and amplify the public health impact of her work. The proposed research will employ mixed methods to study factors related to sustainability of NIMH-funded interventions that promote physical health in mental health settings in Maryland and New Hampshire. By providing salary support, training, freedom from administrative responsibilities, and formal structure for providing mentorship, this award will facilitate her transition from a mid-level to a senior investigator committed to a career in developing and translating interventions to reduce disparities in health for persons with SMI. PUBLIC HEALTH RELEVANCE: Persons with serious mental illness have a large burden of medical comorbid conditions and mortality rates two to three times higher than the general population; effective, sustainable interventions to reduce these health disparities are needed urgently. This application will support a practicing general internist and researcher with a longstanding commitment to improving physical health in serious mental illness in her efforts to gain new knowledge in implementation research methods. The award will enable her to apply these techniques to implement sustainable strategies to decrease health disparities in serious mental illness while providing outstanding mentorship for junior investigators developing research to promote overall health in this vulnerable population.